Abstract
AIMS--To compare the haemoglobin (Hb) H inclusion test with immunocytochemical detection of embryonic zeta chains in screening for alpha thalassaemia. METHODS--Blood samples from 115 patients with relevant clinical history and hypochromic microcytic indexes were screened using the HbH inclusion test and the Variant Hemoglobin Testing System (BioRad, Hercules, CA, USA). RESULTS--The HbH inclusion test was positive in 61 of 115 cases, three of whom had HbH disease confirmed by electrophoresis. The remaining 58 had alpha thalassaemia 1. All three HbH cases and 56 of 58 cases of alpha thalassaemia 1 expressed embryonic zeta chains, giving a specificity of 96.7%. Fifty four of 115 cases had a negative HbH inclusion test, of whom 50 had beta thalassaemia trait and three had iron deficiency. No diagnosis was reached for the remaining patient. CONCLUSION--The immunocytochemical test is as sensitive as the HbH inclusion test in screening for alpha thalassaemia. The presence of zeta chains is highly specific for alpha thalassaemia 1 incorporating the (--/SEA) deletion. The specificity and simplicity of the immunocytochemical test make it the test of choice in screening for alpha thalassaemia.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Chui D. H., Wong S. C., Chung S. W., Patterson M., Bhargava S., Poon M. C. Embryonic zeta-globin chains in adults: a marker for alpha-thalassemia-1 haplotype due to a greater than 17.5-kb deletion. N Engl J Med. 1986 Jan 9;314(2):76–79. doi: 10.1056/NEJM198601093140203. [DOI] [PubMed] [Google Scholar]
- England J. M., Fraser P. Discrimination between iron-deficiency and heterozygous-thalassaemia syndromes in differential diagnosis of microcytosis. Lancet. 1979 Jan 20;1(8108):145–148. doi: 10.1016/s0140-6736(79)90532-4. [DOI] [PubMed] [Google Scholar]
- Robertson E. P., Pollock A., Yau K. S., Chan L. C. Use of technicon H*1 technology in routine thalassaemia screening. Med Lab Sci. 1992 Dec;49(4):259–264. [PubMed] [Google Scholar]
- Simel D. L. Playing the odds. Lancet. 1985 Feb 9;1(8424):329–330. doi: 10.1016/s0140-6736(85)91093-1. [DOI] [PubMed] [Google Scholar]
- Skogerboe K. J., West S. F., Smith C., Terashita S. T., LeCrone C. N., Detter J. C., Tait J. F. Screening for alpha-thalassemia. Correlation of hemoglobin H inclusion bodies with DNA-determined genotype. Arch Pathol Lab Med. 1992 Oct;116(10):1012–1018. [PubMed] [Google Scholar]
- Tan G. B., Aw T. C., Dunstan R. A., Lee S. H. Evaluation of high performance liquid chromatography for routine estimation of haemoglobins A2 and F. J Clin Pathol. 1993 Sep;46(9):852–856. doi: 10.1136/jcp.46.9.852. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tang W., Luo H. Y., Albitar M., Patterson M., Eng B., Waye J. S., Liebhaber S. A., Higgs D. R., Chui D. H. Human embryonic zeta-globin chain expression in deletional alpha-thalassemias. Blood. 1992 Jul 15;80(2):517–522. [PubMed] [Google Scholar]
- Tang W., Luo H. Y., Eng B., Waye J. S., Chui D. H. Immunocytological test to detect adult carriers of (--SEA/) deletional alpha-thalassaemia. Lancet. 1993 Nov 6;342(8880):1145–1147. doi: 10.1016/0140-6736(93)92125-d. [DOI] [PubMed] [Google Scholar]